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Issues with highs - 780g

 
The 780g uses a newer infusion set, so when you remove it verify the plastic tubing is not bent would be the first thing to check. I will repeat myself, when removing the blue plastic funnel from the needle you must rotate until it is fully releasing and falling off into your hand. Next, notify your trainer and inform them about the high BG before making any changes to your pump. Not sure, but it may take up to a week plus before the pump learns your bodies requirements for insulin, so it may be still in the evaluating stage. I would personally be adding bolus to bring the BG levels down as I use a scale of 3U per 5.5mmol/L which has evolved over my many decades of insulin injections. Now, I will add carbs to my pump when you have excess BG readings then read how much insulin has been selected, if the units needed are less than required use the back arrow and modify the carbs until you have the selected the correct solution.
You will get a handle on your bolus thru trial and error, over time by using the CGM to show the response to the injection. keep track of the response, writing down the amount entered and your BG drops while also monitoring the times. By monitoring the active time while the insulin is dropping your BS, you can then modify your active insulin times on your pump to match up with your body. This is why I say it is up to you, the person with diabetes to control your treatment.
 
**Update - I turned off the automatic corrections - kept the smart guard on and it does a pretty good job at keeping my BG in check now. And if I do start to rise, if I miscalculate or I forget to bolus, I can correct manually and this has been working great for me. Not getting the full use of everything it does but I'm much happier with it and can interject when I need to. **

I am having exactly the same issue. Running high all day in automatic mode or smartguard and my control is great in manual mode. I thought I was doing something wrong because everyone I speak to is saying how fantastic it is and I've had nothing but constant highs since I swapped over to the automated mode. So disappointed.
 
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Hey there Private01 - curious to know - did you ever get things sorted out. You sound like my twin in the Medtronic 780G. I've been thinking of giving the pump back to Medtronic - but after almost 3 months of asking for help from Medtronic and my CDE at the hospital I go to (plus I've been posting about my probs on social media) - I've had emails/voice mails from Medtronic wanting to help. Because it's a long weekend (like in the UK - we celebrate Queen Victoria's birthday) - I'll respond to Medtronic next week. Oh the joys of technology - sometimes I think the reason I'm on meds now for mental help - is mainly due to all these gadgets we now use. I never thought about diabetes much the first 45 years (I've been T1D since childhood) - and now - it's like - diabetes is ruling me - not the other way around! Whip it Whip it!!
 
How are things going for your son now with the #780G - my story is same as yours with being high at night - and waking up - despite going to bed under 6.
 
I have been having the same problems as everyone else. The dang 780 doesn't give me near enough insulin for food. It halves it. I go high within a hour after eating and stay there for several hours before it starts to come down. I am sent low through the night and it just doesn't seem to be working. A few times I thought it was my site not working. That is what the slope on my cgm looks like. My graph looks like Mount Everest. Staying high for hours is unacceptable IMO. Medtronic has got to make it safer for people to transition over to the 780. This is NOT SAFE!!!!!!
 
Hey Dee - you've maybe read my posts in other social media accounts about my trial with the #780G (I started on it back in April - but had been trialing the #770G where AutoMode was horrible for me - so kept it in Manual).

I finally have been heard by Medtronic Canada (they're looking into some weird scary situations while I was on holiday - where the pump went slightly wonky) - but I also attended a virtual meeting last week for those of us new to the 780G or wanting to learn more if they're already on the fence post about upgrading. It was excellent, and I learned some new things. A few days later after that virtual meeting, saw not just one but TWO CDE's at my local hospital. Since being on the pump trial back in September, even with requesting help, I've been on my own learning about the pump (thank goodness for forums like this right?).

Main thing, I've got the pump set up correctly. A few tweaks were made - and since then - my blood sugars very rarely have gone above 10 (I have always been tightly controlled - part of the OCD in me). So, maybe best to seek out some advise from your CDE's? I know for myself, it's taken almost 2 months for the SmartGuard (SG) to get to know me, even with my going into Manual Mode.

One thing, what is your ISF (I had to change mine), I:C (I had to change mine slowly as I tested out the system). Other than that, with the algorithm, changing your basal rates won't make any difference. And remember, make sure the basal set up when you're out of SG - should be tested out properly to ensure you don't have whacky blood sugars if bumped out of SG.

I noticed you're in Canada too like myself (I'm an expat - so have a thing for Diabetes UK) - but now live in Ontario!
 
Hey Dee. Your carb ratio is wrong. I started off like this with my endo having my ratio at 15:1 and refusing to change it. I’ve since gone against and am at an 8.5:1 and 10:1 during periods set and I’m now 85+ TIR. And that’s coming from someone that has had a deadset gut full of Medtronic CGM….
 
Can you elaborate with an update. I’m studying this thread and wondering what has happened to everyone.
 
Yeah not sure. I just chimed in the other day and was the last reply. Maybe I scared everyone off???
 
Justin04 said:
Yeah not sure. I just chimed in the other day and was the last reply. Maybe I scared everyone off???
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Well, your latest report was good, as you seemed on track and that’s promising. I get how setting the M 780 with proper Basal and insulin carb ratio would be important. I’m not sure why that would be different on different pumps, say another Medtronic p, but assuming that’s set properly, if you’re over 80% TIR, that’s awesome! And, if you aren’t getting repeated notifications or wild BG numbers that are far from fingerstick numbers, that sounds positive to me. It encourages me to keep 780 on top of my options.
 
I'm so fed up with 780 smart guard simplera, since Oct 24.

I just think the algorithm is too conservative. It also can't cope with my huge dawn phenomenon.

I've been a diabetic since birth, 50 years, on a medtronic pump for 25 years.

It runs me at 11, sometimes up to 14. Then brings me down to 8, for 4 hours. Multiple tiny corrections. But why is it running me at 8?

I'm set to all the tightest settings, 2 hours active, 5.5, carb ratio used to be 1:10, but pump specialist nurse had put it down to 1:8, then 7, now 1:6.

But it's just not working. How can my Hba1c be any good when it's running me at 8 or 9.8, or 10.4 for 6 hours. Surely it should be running me, aiming for 5.5. I expected it to run me to say 5, or 4.6 permanently aiming for optimum.
 
And the hospital just keeps saying, oh you're in range. As if that's good. No, I could get better control myself. I think I could run it, aim to be at BG 5, without smartguard, I think I could get it to run at 5, not 9.8 or 11. So what's the point?
 
Just a thought, but have you tried using a new site for your cannulas, well away from your previous ones?

I was recently running higher than usual for a few weeks until I tried a new location from upper to lower abdomen and it seems to have worked.
 
Well no, actually I haven't, thanks I will. I normally just alternate on different sides of my tummy, with the mio advance they've just started sending. My sensor sits on the inside or back of my upper arm.
 
I have occasional issues with 780 G smartguard, but not with Simplera. If I’m running high I can normally narrow it down to inadequate bolus to cover my carbs, absorption problem, infection or medication like cortisone shot. I’m doing really well right now and hope it continues.

Have you looked at charts and info that’s available on Carelink? I check it too much…like everyday. It can show trends and info the endo may be able to help get the numbers lower.

What A1c is your goal?
 
Hi Oblomov, you are right, the 780 algorithm is way too conservative to keep you on target. I too have spent 2.5 years cursing mine, and reminding myself that I’ve only got 18 months to go until I can get hooked to a t slim and destroy the 780…. As my life has lots of variables eg shift work, manual labour to office work, etc, the whole learning the past isn’t working for me. Off a week of night shift, it’s 4-5 days of horror before it’s learnt enough to not have me basically manually driving the pump while chewing back sugar. Thursdays appointment with my endo (not my regular one) and she said I should have a go at going back into manual mode as my control was better when I looked after it myself using the 640g. I’ve just started using Fiasp so am going to stay in Smartguard for a while to see if the faster insulin responds to the peaks quicker but if not back to manual mode. Just ticks me that I’ll have an algorithm that I can’t use. I do have a high TIR of 80+, but it’s not the pump getting me there, it’s a lot of work from me fudging figures and lying to it to get that success.
 
Thanks Justin, for understanding. My pump nurse suggested coming out of smartguard.
Eh? So a pump has a function, the smart guard that doesn't work, is not 'fit for purpose'. So it's being suggested I come out of it.

Might as well go back to the 670 I had. But seriously read that back. Medtronic's is making millions out of the 780, smartguard is supposed to be the 'thing'. But it's too conservative and doesn't work for someone like me who had reasonable control before. So why is no one holding Medtronic to account on this?
 
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